Measuring Health Disparities: The Choice of Spatial Unit

• Activity Number: 656
• Type: Topic Contributed
• Date/Time: Thursday, August 5, 2010 : 10:30 AM to 12:20 PM
• Sponsor: Section on Statistics in Epidemiology
• Author(s): Carol Gotway Crawford*+ and Zhuo (Adam) Chen
• Companies: CDC and CDC
• Keywords: MAUP ; geospatial analysis ; population health

Abstract

Empirical health disparities studies compare health outcomes between population groups defined by variables including race/ethnicity, gender, socioeconomic status, and most notably spatial units that usually correspond to political jurisdictions. In this study, we propose that, while it is useful to measure population health outcomes at the census tract level to monitor health disparities, studies using other spatial units, such as county and state, also offer critical policy implications. The use of small, homogeneous geographic units allows limited variation in population variables and thusproduces measurements of health disparities that are biased downward. We use data from the 2000 Census to illustrate these ideas and the different inferences that result from spatial analyses using health disparity measurements associated with different choices of spatial units.